Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE credits
Treatment planning for radiotherapy involves different types of imaging to delineate target volume precisely. The most suitable sources to get 3D information of the patient are the computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT modalities. CT is a modern medical imaging technique that allows three-dimensional treatment planning and conformal treatment techniques. By combining CT images with efficient dosimetry software, accurate patient positioning methods and verification and quality assurance good results can be achieved. The CT images show how the radiation interacts with the material based on each tissue has a different attenuation coefficient, so the data can be used for dose calculations in treatment planning.
Radiation oncology is therapeutic modality, in which irradiating cancer cells as target is the main goal while always try to limit the dose to healthy tissues and organs. CT images have good potentials because they can provide high geometrical accuracy and electron density information. Having said that, however, using CT images alone for planning does not provide enough information in order to delineate the target volume accurately because the attenuation in soft tissue is fairly constant therefore the soft tissue contrast is poor. Here, (MR) imaging can be very useful since it has superior soft tissue contrast especially in conditions such as prostate cancer, brain lesions, and head and neck tumors. It should be noted that MR images cannot provide electron density information that is required for dose calculations.
It has been hypothesized that since MRI images have certain benefits in comparison with CT images such as its superior soft tissue contrast which improves contrast resolution between different types of tissues, it would be beneficial to use MRI alone for both target delineation and treatment planning to save time and costs. This was investigated by introducing substitute computed tomography (SCT) which can be interpreted as CT equivalent information obtained by MRI images.
We used data from five patients with intracranial tumors, and reviewed their initial dosimetric treatment plans that were based solely on CT images, that data was also used to evaluate the dosimetric accuracy of our research treatment plans. Optimization plans that are based on CT images and substitute CT (SCT) was compared with each other in the first step. On the second step the treatment plan that was based on SCT images was transferred to the CT images without any changes and comparisons between the dose calculations on both data sets were made. The delivered dose to planning target volume (PTV) and risk organs was compared.
Gamma index results between SCT and transferred plan showed no difference in the dose distribution map in PTV. The maximum difference was in the outer contour to the skull. The average and median dose delivered to PTV was within 0.35% difference studying in all patients.
In conclusion for patients with intracranial tumors the dosimetric accuracy of treatment plans based on SCT and MR images were very accurate, and we demonstrated that it was possible to reach the same dose volume histograms by SCT compared to CT with minimal differences, which were not significant.
2013. , 28 p.